Sunday Morning

It's early Sunday morning and I'm just sitting here at my computer thinking about how much things have changed. Our office manager had gall bladder surgery Friday - and she expects to be back to work tomorrow morning. A surgery that once had a several week recovery time has come so far that Shelly will be back on Monday.

In many ways the insurance billing for the surgery has also come a long ways. A few years ago employees sat at typewriters and typed in claims information. It took several minutes to complete a form which was then mailed to the insurance company. The claim was then passed through many hands from the people in the mail room who opened the envelope to the final processor who makes the decision on whether or not the claim is paid. This was a several week process.

Now most of our claims are sent electronically through the computer. Insurance companies love this. It cuts way down on the amount of time employees are handling the claims which cuts down substantially on their costs. Physicians love this. Their payments come much quicker. Problem claims are found much sooner and dealt with before they are denied. This brings their outstanding receivables (or cash) in much quicker.

Now we even have electronic remittances which will post payments automatically to your practice management system. What will we see next?

Are you billing your insurance claims electronically? For more information on electronic claims submissions visit our page on electronic billing.

Qualifiers for Medisoft

A big thanks to Jan R from Internal Medicine Specialists for her email on qualifiers for Medisoft. We recently had someone ask for a list which we were unable to locate. Here it is.


In reference to the question someone asked about qualifiers (for the Medisoft software) - You can go into the Medisoft website and do a search for qualifiers or I have listed below what the qualifiers are. Hope this helps!
0B - State License Number
1A - Blue Cross Provider Number
1B - Blue Shield Provider Number
1C - Medicare Provider Number
1D - Medicaid Provider Number
1G - Provider UPIN Number
1H - Campus Identification Number
1J - Facility ID Number
B3 - Preferred Provider Organization Number BQ - Health Maintenance Organization Code Number EI - Employer's Identification Number FH - Clinic Number
G2 - Provider Commercial Number
G5 - Provider Site Number
LU - Location Number
SY - Social Security Number
U3 - Unique Supplier Identification Number
X5 - State Industrial Accident Provider Number
This information is typed into the PINS field (under Insurance).

Jan R.

Thanks Jan - we appreciate your help.
Alice

Listing our ebooks on Amazon

Today we received our ISBN #s so that we can now apply to sell our books thru Amazon.com. It's very exciting for us as in the past we've only offered them for sale on our own website and thru Ebay. We now offer the following books in ebook format.

"How To Complete a CMS 1500 Completely and Correctly - Line By Line, Box By Box".

"How to Start Your Own Successful Medical Billing Business"

"12 Marketing Strategies to Grow Your Medical Billing Business"

We are currently working on "How To Complete a UB04 Completely and Correctly" and hope to have it for sale in November.

Let us know your needs and we'll see if we can work them in.

Alice :)

NPI # in Wrong Box Causes Claim Denials

We recently signed up two new doctors for our billing service. The reason they decided to use a service was because their Medicare claims were all being denied. These two doctors are not located in New York so we contacted the Medicare office in their area. It took several calls and we went through many automated systems before finally getting to the bottom of the problem.

We thought perhaps the denials were caused because the Medicare PTAN was not entered on the claim. Maybe they were not yet able to accept claims without both the NPI # and the Medicare PTAN. But these claims denied because the providers put their NPI # in box 17B.

This is just another example of how important it is to understand NPI #s. Many offices still do not know they need a Type II NPI #. If you are receiving any claim denials for NPI #s be sure to download our free copy of "NPI Numbers - Everything You Need To Know About NPI Numbers" .

If you are having a problem with claim denials, you need to read our ebook "How To Complete a CMS 1500 (HCFA 1500) Completely and Correctly - Line By Line, Box By Box" . Avoid costly mistakes. Make sure your claims are filed correctly the first submission.

Purchasing Medical Billing Software

We've had several occasions to look up medical billing software on the internet and always have been frustrated by the sites that sell the software. They ask you all these questions about your practice and how much you want to spend but it's difficult to just compare the different software programs available and find the prices.

Many people ask us on our "Ask the Biller" page about purchasing software. We know about Lytec extensively because we use Lytec every day. We also know about several others, such as Medisoft, Eclipse and Perfect Care as we've had occasion to use them in some of our provider's offices. Some are designed for small practices and some are designed for large groups or hospital billing.

We've decided to put up a page on our website comparing the different medical billing software available. We want to give you an idea of what each of the software packages offers, what type of office they work best for, and how much they cost, etc. We want to use screen shots of each software so you can see what the program looks like before you purchase it and what the cost of each software package is.

Nellie needs help with Medisoft qualifiers

I recently got this question on our Ask the Biller page.

Do you have a list of the qualifiers that are needed for each area in medisoft (eg. what is the qualifier code when you enter a procedure that is not on your system and the bottom box says code ID qualifier.)? Also the ref dr's need a qualifier and ins co's? Do you have a list of these?

Please share with me...

sincerely,

Nellie

Michele answered

Hi Nellie,
Thanks for your question. I use Lytec, which is similar to Medisoft, but Lytec does not have the qualifier fields like Medisoft does. I tried to find a list of the qualifiers used in Medisoft but I wasn’t able to. The only qualifiers I know of are the ones to identify the type of insurance carrier in electronic claims submission which is not what you are looking for. I will post your question and maybe another Medisoft user could email us if they have lists of qualifiers.


So if anyone can help Nellie, we would appreciate it.

Thanks,
Alice

Newsletter published today

Hi,

Well, we sent out our free monthly newsletter today. If you are not yet a subscriber, be sure to sign up for your free copy at Solutions Medical Billing.

This month's newsletter covered

• starting a new private medical practice
• NPI registry website down
• Bundling CPT Codes
• New look to our website
• medical billing and coding schools
• projects we are currently working on

If you have any suggestions for articles, let us know. We're here to answer your questions.

See you later.

Alice

HCFA Envelopes too large

I'm having a bit of a problem with my large HCFA envelopes. According to the new rate increases at the post office my large HCFA envelopes that hold multiple claims unfolded with the address of the insurance carrier showing through the window are one inch too long to be considered a large envelope. They want me to pay a package rate which is quite a bit more than the large envelope rate. Now if the envelope were addressed sideways instead, it would be alright but the height can only be 12" and these envelopes are 13" tall.

I found a solution to the envelopes I have in stock. I fold over the bottom edge and tape it with packing tape to make the envelope only 12" high. The HCFA form we place in the window must then be folded about an inch from the bottom so the address shows through the window.

The problem is that I need to reorder. I hate to have to do this to the next 500 envelopes when thousands of others must be having this same problem and the solution would be in making the envelopes 1" shorter. If anyone out there has any connections with the people who manufacture these envelopes, please convey my wishes.

We use many of these envelopes every week. I don't want to go back to having to print labels for each insurance and putting them in plain envelopes. Has anyone else run into this problem. I'm eager to hear.

Alice

What is Solutions Medical Billing

Every once in awhile someone sends us an email thanking us for an answer we have provided on the "Ask the Biller" page or for writing our newsletter. I got one today saying thanks for all the information that we share in our newsletter and that it is very helpful to them.

Maybe this sounds a little corny, but we feel good when we help someone. It doesn't take a lot of time to answer a question and sometimes it saves the reader a big headache. When we started our business in 1994, we didn't have anyone willing to help us get answers to our questions. And we had a lot to learn. It wasn't long before others started asking us questions. Mostly they asked us about starting their own medical billing business. Remembering how difficult it was for us to find answers, we vowed to help others so we took the time to answer their questions.

In fact, so many people called us about starting their own medical billing business that we wrote our first book about it - "How to Start Your Own Successful Medical Billing Business" in 1999. We found that people who wanted to start their own business had lots of questions and we could be on the phone for an hour answering them all. There was too much to tell them at one sitting. We've sold hundreds of copies of that book and gotten wonderful response from our readers. We found that we enjoy helping others.


Solutions Medical Billing is a small business, run by myself and my daughter. There are nine of us (all friends) who work on about 50 accounts of a variety of providers. Many of our doctors are within a 20 mile radius and we pick up their information weekly but many of our doctors we've never even met. We've developed a great support team of people we can call on when challenges do arise or when one of our readers asks us a question that we cannot answer.

Don't get me wrong, we're not naive. We have been burned by a few others we thought were trying to help us. We had the choice of being mad at them and never reaching out again or remembering who you cannot trust and go on helping when we can. We just like helping people.

So keep sending your questions to us on our ask the biller page. We'll keep answering them to the best of our ability. If you have any suggestions for our newsletter articles, send them along too. We truly enjoy helping others.

Alice

Welcome

Hi, welcome to my blog. My daughter/partner Michele and I offer a website on medical insurance billing. We offer help to those in the medical insurance billing field who have questions on our Ask The Biller page. We've decided to take some of the questions that seem to be asked about the most often and write about them on our new blog.

We also publish a monthly newsletter free of charge to anyone interested in reading it. You can sign up to receive your free subscription here. We write about news in our field and offer helpful hints on many subjects from getting your claims paid correctly and quickly to small things that will help the office run more smoothly.

We also offer a few ebooks on the subject of medical insurance billing. You can read about them on our website. Thanks for visiting.

Alice Scott